Laserfiche WebLink
OF TRUSTEE!! <br /> JamesJames Culbertson, Pres. : AQUIN LOCAL HEALTH DI:* SERVING Patricia E. V an Spronsen nuccl, son Hazelton venue' City of Lodi <br /> Anthonette Van 1601 East AP. O. Box 2009 San Joaquin County <br /> Clty of Escalon <br /> Earl Pimentel Stockton, Call fornIa 95201' C ityty o Manteca <br /> Fern Supbes <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John 0. Mast, M.D. City of Stockton <br /> City of Tracy <br /> William J. Wade Jopl Khanna. M.O.. M.P.H.. District Health Officer San Joaquin County <br /> Mary Anna love San Joaquin County <br /> i <br /> Facility Name <br /> Address _ ', l Ok 1(7 /"rC�iwu S Z f <br /> Date of Inspection /U Inspector �� , � <br /> MONITORING ALTERNATIVE 05 % /-3 <br /> V Annual precision test on tank(s) and piping. <br /> 1` Daily inventory reconciliation with submission of quarterly statement 'regarding <br /> compliance with allowable variation. <br /> Pipeline leak detectors on pressurized piping. <br /> Daily operational check of suction piping function. <br /> Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker(` <br /> Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> 1� Precision test(s) trust be performed by and results submitted to <br /> this office within 30 days of the test. <br /> Pipeline leak detectors must be installed on pressurized piping by ! /S <br /> �3} Daily inventory reconciliation must be started immediately, with records maintained <br /> // at the facility for review. <br /> 4. Document daily check of suction piping function starting immediately. <br /> 5. Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and variations that j <br /> exceeded allowable.* The first statement is due by t'6 I <br /> 6 1 <br /> Dispenser meter(s) must be calibrated by /Z��S ? with copy of f <br /> certification or Weights and Measures sticker numbe submitted to this office. j <br /> If the above compliance dates cannot be met, contact this office prior to the specified <br /> c <br /> date. <br /> * If allowable daily inventory variation is exceeded. refer to Section 2644( f) for <br /> required actions. <br /> 3-86 UGT 1 <br /> 0 <br />